Individual provider Active NPI

Joseph Santos Santiago, M.D.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1366413338
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36856 Issued in MO
Practice address
2900 Lemay Ferry Rd
Suite 217
Saint Louis, MO 63125-3900
Phone
(314) 894-8865
Fax
(314) 894-7409
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36856 MO Primary

Addresses

Primary practice location

2900 Lemay Ferry Rd
Suite 217
Saint Louis, MO 63125-3900

Mailing address

2900 Lemay Ferry Rd
Suite 217
Saint Louis, MO 63125-3900
Phone (314) 894-8865

Other identifiers 1

IdentifierTypeStateIssuer
202431904MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020000821 MO Practitioner - Family Practice 2567655764 Reassigns benefits to 2 organizations
Practice locations: Saint Louis, MO; St Louis, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Seasons Medical Group of Missouri PC CurrentSince Feb 11, 2026 Accepting new patients
Seasons Hospice & Palliative Care of Missouri, LLC Family Medicine PastSince Feb 11, 2026 Accepting new patients

Locations

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 525-1887

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

3660 S Geyer Rd
Ste 120
Saint Louis, MO 63127
Phone (314) 909-6200

12700 Southfork Rd
Ste 105
Saint Louis, MO 63128
Phone (314) 525-1887

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1366413338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "SUITE 217",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-894-8865",
            "fax_number": "314-894-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "SUITE 217",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-894-8865",
            "fax_number": "314-894-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JOSEPH",
        "middle_name": "SANTOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202431904",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.